NPIMap

Individual provider Active NPI

Jeffrey Allen Klein, M.D.

  • Diagnostic Radiology Physician
  • Madison, WI
National Provider Identifier
1174796478
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
52411 Issued in WI
Practice address
1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone
(608) 252-8000
Fax
(608) 283-7361
NPI assigned
Apr 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 52411 WI Primary

Addresses

Primary practice location

1313 Fish Hatchery Rd
Madison, WI 53715-1911

Mailing address

1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone (608) 252-8000

Other identifiers 1

IdentifierTypeStateIssuer
1174796478MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jklein261741@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110412000708 WI Practitioner - Diagnostic Radiology 8224212469 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Southern Illinois University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2251 N Shore Dr
Rhinelander, WI 54501-6710
Phone (715) 361-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52411WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Dec 21, 2010 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Dec 19, 2024 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Dec 19, 2024 Accepting new patients
The Howard Young Medical Center, Inc. Current Accepting new patients
The Howard Young Medical Center, Inc. CurrentSince Dec 19, 2024 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Dec 19, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Dec 21, 2010 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Dec 19, 2024 Accepting new patients
Aspirus Eagle River Hospital & Clinics, Inc. CurrentSince Dec 19, 2024 Accepting new patients
Aspirus Eagle River Hospital, Inc. CurrentSince Dec 19, 2024 Accepting new patients
Mercy Health System Corporation Current Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

29980 Network Pl
Chicago, IL 60673

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

2251 N Shore Dr
Rhinelander, WI 54501
Phone (715) 361-2300

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

401 W Mohawk Dr
Tomahawk, WI 54487
Phone (715) 453-7200

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Interoperability endpoints

  • Direct secure messaging: jklein261741@direct-ehr-ssmhc.com

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1174796478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151911",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151911",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "52411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174796478",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jklein261741@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jklein261741@direct-ehr-ssmhc.com",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.